ROM and Flexibility

Question 1

connective tissue (7)

Answer 1

• bone
• tendon
• muscle
• skin
• hyaline cartilage
• joint capsule
• fascia

Question 2

building block of connective tissues, found in all connective tissue

provides tensile strength

Answer 2

collagen

Question 3

< 1% found in connective tissue. Recoil of tissues

Answer 3

elastin

Question 4

amount of tension or load placed on the tissues

Answer 4

stress

Question 5

proportional degree of elongation that occurs during stress

Answer 5

strain

Question 6

ability of tissues to return to their previous resting state

Answer 6

recovery

Question 7

gradual lengthening of tissues when they are subjected to constant or repeated stress over a long duration

Answer 7

creep

Question 8

ability of a tissue to return to its original resting length when stress is removed

Answer 8

elastic deformation

Question 9

tendency of tissue to assume a new and greater length after the stretch force has been removed

Answer 9

plastic deformation

Question 10

connective tissue properties (3):

Answer 10

• warmer temp = greater flexibility
• connective tissue is a passive restraint to joint motion
• muscle tissue is an active restraint to joint

Question 11

the ability of a muscle to relax and yield to a stretch force

the ability to move a single joint or series of joints smoothly and easily through an unrestricted, pain-free ROM

Answer 11

flexibility

Question 12

the amount of movement available to a joint moving within its anatomic range

Answer 12

ROM

Question 13

What determines flexibility (6):

Answer 13

• muscle length
• joint ROM
• joint mobility
• extensibility of surrounding soft tissues
• joint arthrokinematics and osteokinematics
• strength

Question 14

active mobility or active ROM (AROM)

Answer 14

dynamic flexibility

Question 15

passive mobility or passive ROM (PROM)

Answer 15

passive flexibility

Question 16

How to increase flexibility and ROM (3)

Answer 16

• stretch what’s tight (mm, restricted ROM, jt capsule)
• joint mobilization (if indicated)
• strengthen what’s weak.

Question 17

4 types of stretching:

Answer 17

• static (passive)
• dynamic (active)
• ballistic (BAD)
• proprioceptive neuromuscular fascilitation (PNF)

Question 18

stretch: placing a muscle in a fully elongated position and holding that position for a period of time

goals:

• prevent or minimize risk of soft-tissue injury during activity
• improve flexibility
• prevent contracture

Answer 18

static stretching

Question 19

stretch:
performed actively by moving joints
- body weighted or eliminated position
- through avaiable range
- gradually increase range and speed
- does not diminish torque production
- good to warm-up for sport/activity

Answer 19

dynamic stretching

Question 20

stretch:
bounce at the end of ROM

• high risk injury to the connective and contractile tissue with this type of stretching
• likely will NEVER use in rehab

Answer 20

ballistic stretching

Question 21

stretch:

reflex inhibition and subsequent elongation of the contractile elements of the muscle

involves the Golgi Tendon Organs in the myotendinous junction, and the muscle spindles

Answer 21

proprioceptive neuromuscular facilitation (PNF)

Question 22

a reflex relaxation that occurs in the same muscle where the golgi tendon organ is stimulated

(via isometric or isotonic contraction)

Answer 22

autogenic inhibition

Question 23

contracting the opposing muscle group to that being stretched in order to achieve a reflex muscular relaxation that occurs in the muscle that is opposite the muscle where the golgi tendon organ is stimulated

Answer 23

reciprocal inhibition

Question 24

types of PNF (3):

Answer 24

• hold relax
• contract relax
• slow reversal hold

Question 25

PNF: - gentle isometric contraction of muscle being stretched - 6-10 seconds followed by stretch into new range

Answer 25

hold relax

Question 26

PNF: - gentle isotonic contraction of muscle being stretched - 6-10 second followed by stretch into new range

Answer 26

contract relax

Question 27

parameters for stretching/flexibility/ROM

Answer 27

- ALWAYS warm up 5-10 minutes - determine mode - intensity: mild to moderate stretch, no pain - duration: 30-60 seconds, 3-5x per series - frequency: daily ( must stretch at least 3x/wk to gain and 1x/per wk to maintain

Question 28

due to scar tissue formation between tissue structures and results from the healing or union of two injured or torn parts collagen fibers are highly unorganized initially but organize based on stresses placed on it

Answer 28

adhesions

Question 29

adaptive shortening of the muscle-tendon unit and other soft-tissues that crcoss or surround a joint qhich results in significant resistance to passive or active stretch and limitation of ROM can be transient or permanent

Answer 29

contractures

Question 30

longer a contracture exists OR the greater % of normal tissue replaced by scar tissue or bone, the more difficult it becomes to regain optimal mobility of soft tissue =

Answer 30

more likely contracture will become irreversible

Question 31

stretch parameters for contractures:

Answer 31

- requires low load, long duration (LLLD) stretching - aggressive - prolonged stretch into restriction 20-60 mins - may be done in conjunction with heating - bracing, serial casting

Question 32

precautions to stretching (5):

Answer 32

- avoid ballistic stretching to allow relaxation and prevent injury - avoid overstretching - use caution with known diseases - stretch carefully if swelling/edema present or in patient has been immoblized for prolonged length of time - residual soreness should not last > 24 hrs

Question 33

contraindications to stretching (5)

Answer 33

- if motion is limited by a bony block - across an acute of non-unioned fracture - acutely inflamed and infected tissue - hypermobile tissues or joints - hypomobile tissues that provide structural or neuromuscular support